A key trend that Long said has become more prominent over the course of the pandemic is the overall reduction in diagnostic visits — and thus prescriptions generated — that took place in 2020. Last year, institution, doctor or telehealth visits to get a diagnosis decrease by roughly 21% year over year, or about 920 million visits.
This was even as telehealth grew as a contributor to prescriptions being generated. Long noted that even as telehealth visits peaked last April, comprising 17% of all healthcare visits, the overall trend is that telehealth vists generate fewer scripts than face-to-face visits, particularly in allergy, dermatology, primary care, psychiatry, endocrinology and neurology.
"There are not a lot of labs or vitals, associated with a telehealth visit so doctors may be less willing to generate a new therapy start remotely and they spend less time on telehealth visits than they do an office visit," Long said.
As the pandemic changed the way people visited their physicians, it also had an impact on how people have their medication administered. Long noted that in oncology in particularly, more emphasis has been placed on self-administered medication. "If you’re a product manufacturer and you have a self-administered drug you had an advantage over a drug that needed to be infused or for which you had to leave your house," he said.
Taking a look at the overall pharmaceutical market, Long said the total market on a dollar basis grew 5%, marking a slowdown over other recent years. "It’s slowing down, there are less price increases, less utilization,” he said. “Traditional is growing 2%. Specialty was over 10% in 20l8 and 20l9, and grew only 8.4% in 2020, which fits into the narrative I’ve given you before. Traditional is very important to the retailers. That’s where the bulk of retailer business is. That has strengthened."
Specialty in the total market, now has a little greater than a 49% share of the total market, and Long expects specialty to be 50% in the next year or so. Long also predicted there will be more specialty and biosimilars coming to the marketplace as the healthcare system looks to contain costs.
On the vaccine front, Long said there was big falloff or slump in vaccinations in the beginning of 2020, and although they have started to recover, vaccination rates are not yet back to pre-pandemic levels. As COVID-19 vaccines become more widely available, Long noted that Pfizer is looking to reduce the time to manufacture its vaccine, Novartis is helping with manufacturing and Johnson & Johnson's vaccine is expected to receive emergency use authorization soon.
Despite the difficulties, Long said the supply chain has held up well amid the pandemic. He congratulated manufacturers, the API manufacturers, for not having a lot of out of stocks, and pointed out that retailers stepped up, starting with masks, hand sanitizer, and toilet paper.
"Retail pharmacies have played a huge role and continue to play a huge role with COVID-19," he said "Now even more you can play a bigger role in the future. There are tremendous opportunities ahead."